Patient Complaints

Soft complaint → L | Clarity complaint → M | Loudness complaint → P | Occlusion complaint → venting | Noise complaint → noise reduction, not gain | Medical complaint → referral

“Soft speech is too soft.”

→ Increase L (soft gain)

They aren’t hearing quiet sounds

“People sound unclear / muffled / I can’t understand words.”

→ Increase M (medium gain)

They hear the sound but not the clarity

“Everyone sounds the same / voices blend together.”

→ Increase M (speech frequencies)

Clarity issue, NOT volume issue

“Speech is too sharp / harsh.”

→ Decrease high-frequency gain (especially P)

Too much treble = harsh

“Everything is too loud.”

→ Decrease P (loud gain)

Check UCL but don’t over-lower L or M

“Sudden loud sounds are uncomfortable.”

→ Decrease P / adjust MPO

Sharp, startling peaks = peak (P) gain problem

“Normal conversation is too loud.”

→ Decrease M

Don’t reduce L unless soft sounds are also loud

“My voice sounds hollow / in a barrel / echoey.”

→ Increase venting / more open dome

(This is occlusion)

“My voice is too loud.”

→ More venting OR reduce low-frequency gain

“It feels like my ears are plugged.”

→ Use larger vents / more open fit

Classic occlusion problem

“Background noise is too loud.”

→ Increase noise reduction OR directionality

NOT gain adjustments

“I hear too much environmental noise (rustling, dishes, paper).”

→ Slightly decrease high-frequency gain

HF amplification causes sharp little noises to pop out

“Wind noise is bad.”

→ Turn on wind noise management

Not a gain problem

“Feedback / squealing.”

→ Improve seal (bigger dome / mold)

→ Run feedback manager

NOT gain decrease first

“The hearing aid sounds dead / weak.”

→ Check wax guard → mic → battery

NEVER jump to programming first

“Sound is distorted.”

→ Wax → moisture → receiver → then repair

Distortion is rarely a gain issue

“Volume seems to change by itself.”

→ Turn off auto features (auto VC, adaptive gain)

→ Check for moisture

→ Verify not user error

“Noise program doesn’t help.”

→ Increase directional mic strength

→ Add stronger NR

→ Ensure they’re facing the talker

“Music sounds bad.”

→ Reduce noise reduction + directionality

→ Increase low frequency gain

→ Use music program

“My ear hurts”

→ Refer

Never adjust

“There’s drainage / blood.”

→ Immediate referral

Do NOT touch the ear or device.

Sudden hearing change (better OR worse)

→ Refer medically

Not a fitting issue